October is Breast Cancer Awareness Month, a campaign that aims to raise both awareness of breast cancer and funds to help support breast cancer charities. Breast cancer is the most common cancer affecting women in the UK, with one woman being diagnosed every 10 minutes. Approximately 55,000 women and 370 men are diagnosed annually in the UK, with 1 in 7 women developing the disease in their lifetime. [1, 2] As with all cancers, identifying and treating the disease early is vital for improving survival rates;  therefore, with 47% of women in the UK not checking their breasts regularly,  raising awareness of the importance of early detection is paramount.
What are the signs and symptoms?
Common signs and symptoms of breast cancer include: [4, 5]
• A lump or swelling in the breast, upper chest or armpit
• Changes in the size or shape of the breast
• A change in skin texture (e.g. puckering or dimpling of the skin)
• A change in colour of the breast (e.g. it may look red or inflamed)
• A rash, crusting or any other change of the nipple (e.g. inversion)
• Unusual discharge from the nipple
How can changes be identified?
There is no special way to check the breast area. The most important thing is to check regularly so that each individual knows what is ‘normal’ for them, and anything new or different can be recognised.  It is also important to be aware that breasts feel different throughout the menstrual cycle, often feeling ‘lumpier’ just before and during a period.  The whole breast area should be checked, including up to the collarbone and the armpits.
A simple guide to use is ‘TLC’ :
• Touch the breast to identify anything new or unusual
• Look for changes
• Check any changes with your GP
National screening programme
In addition to self-examination, all women between the ages of 50 and 70 in the UK are recommended to attend breast cancer screening every 3 years because of an increased risk of developing the disease with age. This involves having a mammogram (an X-ray of the breast tissue) to identify changes at an early stage.  As with many other areas of the National Health Service (NHS), breast cancer screening services were paused during the height of the COVID-19 pandemic. It is therefore more important than ever for women to get checked by their GP if they notice anything unusual. 
What are the risk factors for breast cancer?
Although the exact cause of breast cancer is not fully understood and is thought to be a combination of lifestyle, genetics and environment,  there are several factors that are known to increase the risk :
• Sex and age – 80% of cases are diagnosed in women over the age of 50
• Height and weight – being tall, overweight or obese
• Family history of breast cancer
• Previous diagnosis of breast cancer
• Previous diagnosis of a non-cancerous breast lump
• Alcohol consumption
Keeping physically active, maintaining a healthy weight and avoiding alcohol are all ways that individuals can reduce their risk. 
Treatment and survival rates
The treatment for breast cancer depends on a variety of factors such as the stage (how large the tumour is and how far it has spread) and the grade (how abnormal the cancer cells look microscopically) of the cancer,  whether the cancer cells have oestrogen receptors, and whether the cancer cells have human epidermal growth factor receptor 2 (HER2) receptors. 
The initial treatment of breast cancer is usually surgical removal.  After surgery, treatments such as chemotherapy, radiotherapy, hormonal therapy (if oestrogen receptor–positive) and targeted therapy (if HER2 receptor–positive) may be used to prevent recurrence. [7,9]
Breast cancer survival has vastly improved over the last 40 years thanks to a combination of earlier detection through screening, improvements in treatments and care, and faster diagnosis. The overall survival rates for women with breast cancer in England are now: 
• 95% for 1 year or more after diagnosis
• 85% for 5 years or more after diagnosis
• 75% for 10 years or more after diagnosis
With more personalised treatments targeting specific cancer cell types on the horizon,  the hope is that these figures will continue to improve and allow those affected to live long, healthy lives.
So, let’s all join the fight against breast cancer by making Breast Cancer Awareness Month 2021 the time to start some regular ‘TLC’ and by passing the message on to those we love and care for to do the same.
Please see the following websites for more information and support about breast cancer:
The information in this article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content is for general information purposes only. Always seek the guidance of your doctor or other qualified healthcare professional with any questions you may have regarding your health or medical condition.
1. UK Medical. Breast Cancer Awareness Month. Available at: https://www.ukmedical.com/breast-cancer-awareness-month. Accessed October 2021.
2. Breast Cancer Now. Facts and statistics 2021. Available at: https://breastcancernow.org/about-us/media/facts-statistics. Accessed October 2021.
3. Breast Cancer Now. Almost half of UK women do not check their breasts regularly for signs of breast cancer. Available at: https://breastcancernow.org/about-us/media/press-releases/almost-half-uk-women-do-not-check-their-breasts-regularly-signs-breast-cancer. Accessed October 2021.
4. Breast Cancer Now. Breast cancer symptoms. Available at: https://breastcancernow.org/information-support/have-i-got-breast-cancer/signs-symptoms-breast-cancer Accessed October 2021.
5. Cancer Research UK. Breast awareness. Available at: https://about-cancer.cancerresearchuk.org/about-cancer/breast-awareness?_gl=1*1iuytbs*_ga*MTQxNTg1MDMyOC4xNTcwNzA3MTEy*_ga_58736Z2GNN*MTYzNDEzMDQzNy4xMi4xLjE2MzQxMzA1NDIuMjk.&_ga=2.58770788.852426066.1634123604-1415850328.1570707112. Accessed October 2021.
6. Breast Cancer Causes. Available at: https://breastcancernow.org/information-support/have-i-got-breast-cancer/breast-cancer-causes. Accessed October 2021.
7. National Health Service. Breast cancer in women: Overview. Available at https://www.nhs.uk/conditions/breast-cancer. Accessed October 2021.
8. About Breast Cancer Staging and Grading. Available at: https://www.cancerresearchuk.org/about-cancer/breast-cancer/stages-types-grades/about-breast-cancer-staging-grades. Accessed October 2021.
9. Receptors for Breast Cancer. Available at https://www.macmillan.org.uk/cancer-information-and-support/breast-cancer/receptors-for-breast-cancer. Accessed October 2021.
10. Cancer Research UK. Survival. Available at https://about-cancer.cancerresearchuk.org/about-cancer/breast-cancer/survival. Accessed October 2021.
11. Personalised Medicine at a Glance: Breast Cancer. Available at: https://www.esmo.org/for-patients/personalised-medicine-explained/Breast-Cancer. Accessed October 2021.
Author: Suzanne Brunt BM | Medical Writer | Porterhouse Medical